Published online Feb 28, 2016. doi: 10.5319/wjo.v6.i1.1
Peer-review started: July 27, 2015
First decision: October 13, 2015
Revised: October 22, 2015
Accepted: December 7, 2015
Article in press: December 8, 2015
Published online: February 28, 2016
Ménière’s disease (MD) is a common cause of recurrent vertigo. Its pathophysiology is still unclear and controversial. The most common histological finding in postmortem temporal bone studies of patients is endolymphatic hydrops (EH). However, not all cases of hydrops are associated with MD and it may represent the end point of various etiologies. The diagnostic criteria for MD have undergone changes during the past few decades. A recent collaboration among specialty societies in United States, Europe and Japan has given rise to a new set of guidelines for the diagnosis and classification of MD. The aim is to develop international consensus criteria for MD that would help improve the quality of data collected from patients. The diagnosis of MD can be difficult in some cases as there is no gold standard for testing. Previous use of audiometric data and electrocochleography are poorly sensitive as screening tools. Recently magnetic resonance imaging as a diagnostic tool for identifying EH has gained popularity in Asia and Europe. Vestibular evoked myogenic potentials are also used but lack specificity. Finally, the treatment for MD has improved with the introduction of intratympanic treatments with steroids and gentamicin as well as less invasive treatment with the Meniett device.
Core tip: The pathophysiology of Ménière’s disease (MD) is still unclear and controversial. The most common histological finding in postmortem temporal bone studies of patients is endolymphatic hydrops. This finding is utilized in the newest method of diagnosis using magnetic resonance imaging with intratympanic or intravenous gadolinium. Changes to the diagnostic criteria have been proposed with collaboration from various international societies. This will help in communication and improve quality of published data. Finally, the use of intratympanic steroids and Meniett pressure treatments offers less invasive and destructive treatments for patients with MD.